How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $8.91 Median $28.18 Typical High $50.12 | Facility | None | $8.91 | $28.18 | $50.12 |
Aetna Setting Professional Modifier None Typical Low $14.79 Median $14.79 Typical High $27.54 | Professional | None | $14.79 | $14.79 | $27.54 |
Ambetter Setting Professional Modifier None Typical Low $18.62 Median $23.99 Typical High $23.99 | Professional | None | $18.62 | $23.99 | $23.99 |
Anthem BCBS Setting Professional Modifier None Typical Low $12.59 Median $15.85 Typical High $21.88 | Professional | None | $12.59 | $15.85 | $21.88 |
CareSource Setting Professional Modifier None Typical Low $16.22 Median $16.22 Typical High $18.20 | Professional | None | $16.22 | $16.22 | $18.20 |
Cigna Setting Professional Modifier None Typical Low $14.79 Median $14.79 Typical High $14.79 | Professional | None | $14.79 | $14.79 | $14.79 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $26.92 Median $47.86 Typical High $69.18 | Facility | None | $26.92 | $47.86 | $69.18 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $14.79 Median $14.79 Typical High $35.48 | Professional | None | $14.79 | $14.79 | $35.48 |
Molina Setting Professional Modifier None Typical Low $10.96 Median $12.88 Typical High $12.88 | Professional | None | $10.96 | $12.88 | $12.88 |
SummaCare Setting Professional Modifier None Typical Low $14.79 Median $15.49 Typical High $19.05 | Professional | None | $14.79 | $15.49 | $19.05 |
United Setting Facility Modifier None Typical Low $12.88 Median $14.45 Typical High $17.78 | Facility | None | $12.88 | $14.45 | $17.78 |
United Setting Professional Modifier None Typical Low $12.02 Median $13.80 Typical High $23.44 | Professional | None | $12.02 | $13.80 | $23.44 |
4 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $7.41 Median $7.41 Typical High $8.91 | Professional | 52 · Reduced service | $7.41 | $7.41 | $8.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.95 Median $2.95 Typical High $3.55 | Professional | 53 · Discontinued | $2.95 | $2.95 | $3.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.24 Median $2.24 Typical High $2.63 | Professional | 55 · Aftercare only | $2.24 | $2.24 | $2.63 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.48 Median $1.48 Typical High $1.78 | Professional | 56 · Pre-op care only | $1.48 | $1.48 | $1.78 |
Where Ohio sits
The same service costs 2.8 times more in Alaska than in Louisiana. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Ohio· 47th of 51
$14.79
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.